分化型甲状腺癌应用全甲状腺切除术与次全甲状腺切除术的疗效及安全性比较  

Effects and Safety of Total Thyroidectomy and Subtotal Thyroidectomy in the Treatment of Differentiated Thyroid Carcinoma

作　　者：张筱扬[1] 张冠男[1] 王文胜[1] 赵爱国[1] 李帅[1] 湛喜梅 张双林[1] ZHANG Xiao-yang;ZHANG Guan-nan;WANG Wen-sheng;ZHAO Ai-guo;LI Shuai;ZHAN Xi-mei;ZHANG Shuang-lin(Breast and Thyroid Surgery,The First Affiliated Hospital of Henan University,Kaifeng 475001,Henan Province,China)

机构地区：[1]河南大学第一附属医院乳腺甲状腺外科,河南开封475001

出　　处：《罕少疾病杂志》2021年第2期14-15,共2页Journal of Rare and Uncommon Diseases

基　　金：河南省医学科技攻关计划项目(81601368)。

摘　　要：目的探讨分化型甲状腺癌(DTC)应用全甲状腺切除术与次全甲状腺切除术的疗效及安全性。方法选取我院2017年8月至2018年8月收纳的确诊为DTC患者200例,其中100例患者进行全甲状腺切除术,即全切组,此外100例患者进行患侧峡部以及腺叶切除,即次切组,依据手术方法的不同将其分为全切组与次切组各100例,比较两种术式的临床疗效与安全性。结果全切组复发率为1.00%,次切组复发率为12.00%,次切组复发率要显著高于全切组,差异有统计学意义(P<0.05);全切组患者并发症发生率为73.00%,次切组患者并发症发生率为48.00%,全切组并发症发生率要显著高于次切组,差异有统计学意义(P<0.05);全切组患者甲状腺旁腺功能减退和喉返神经损伤人数要显著高于次切组,差异有统计学意义(P<0.05);两组出现低血钙人数经比较差异无统计学意义(P>0.05)。结论对于DTC患者选择全切除术和次切除术各有优劣,在临床治疗中还是要依据患者疾病类型进行选择。Objective To explore the effects and safety of total thyroidectomy and subtotal thyroidectomy in the treatment of differentiated thyroid carcinoma(DTC).Methods 200 patients with DTC admitted to the hospital between August 2017 and August 2018 were selected as the subjects,including 100 patients treated with total thyroidectomy(the total resection group)and 100 patients treated with resection of isthmus and lobectomy on the affected side(the subtotal resection group).The clinical effect and safety were compared between the two groups.Results The recurrence rate in the total resection group(1.00%)was significantly lower than that in the subtotal resection group(12.00%)(P<0.05).The incidence rate of complications in the total resection group(73.00%)was significantly higher than that in the subtotal resection group(48.00%)(P<0.05).The number of patients with hypoparathyroidism and recurrent laryngeal nerve injury in the total resection group was significantly larger than that in the subtotal resection group(P<0.05),but there was no statistically significant difference in the number of patients with hypocalcemia between the two groups(P>0.05).Conclusion Total thyroidectomy and subtotal thyroidectomy have their own advantages and disadvantages in the treatment of DTC.Clinically,the treatment method should be chosen according to the patient’s disease type.

关 键 词：甲状腺癌 全甲状腺切除术 次全甲状腺切除术 安全性 

分 类 号：R736.1[医药卫生—肿瘤]